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Cirrhosis

KOL Interview: Can You Discuss Any Recent Breakthroughs in the Management of Cirrhosis?

In this video, Sherona Bau, NP, at Pfleger Institute at UCLA, shares the latest advancements in cirrhosis management, including newly FDA-approved medications and updated AASLD (American Association for the Study of Liver Diseases) guidelines. While there are still limited medications specifically for cirrhosis, recent developments provide promising options for patients with liver disease.

One key update is in the management of portal hypertension, where AASLD now recommends non-selective beta blockers like carvedilol for variceal bleeding prophylaxis, particularly due to its vasodilatory effects. Patients with medium or large varices are advised to take these medications to reduce bleeding risks. Another significant procedure being emphasized is the TIPS (Transjugular Intrahepatic Portosystemic Shunt), which is considered for patients with recurrent variceal bleeding or refractory ascites. However, it is generally preferred for those already on a liver transplant list, as there is a small risk of liver failure.

There have also been notable advancements in treating Primary Biliary Cholangitis (PBC) with two newly FDA-approved medications: Ivarix (approved June 10) and Cadazopa (approved August 14). While these treatments are not approved for decompensated cirrhosis, they are safe for Child-Pugh Class A patients, though providers are advised to discontinue treatment if the disease progresses to Child-Pugh Class B or C. Additionally, for patients with Metabolic Dysfunction-Associated Steatohepatitis (MASH), the FDA recently approved Rivumet on April 9, marking the first-ever FDA-approved therapy for MASH with liver fibrosis (F2-F3). Although it is not yet approved for cirrhotic patients, further data is expected soon.

As liver disease management continues to evolve, staying informed on new treatments and best practices is crucial for improving patient outcomes. For more details, visit the GHAPP website and subscribe for expert insights on liver disease care!

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